Q: I am an unmarried male aged 27 years and working in a software organisation at Mumbai. Eight years ago, during a medical test, doctors from the Navy Hospital, Mumbai disqualified me due to hypertension, 150/100 -90 mm Hg. Immediately I consulted my family doctor and started regular BP monitoring. Family doctor referred me to a Government Hospital in Mumbai for through checkup due to high BP readings. Then I have done full check up at the Government Hospital in Mumbai. I have done ECG, Blood Tests, USG, Urine (RE/ME, 24 hrs), 3D echo, stress test, Blood Lipid Profile, HIV test, etc and they did not show any abnormality. I have done these tests at regular intervals but no conclusion was made. Then I have stooped the tests because I do not have any symptoms to make me feel that I have a high blood pressure. I used to check BP once in four months by my Family Doctor. Based on Family Doctor's advice, I joined Yoga Classes 4 years ago. I have done Yoga for almost one year then Yoga activities got reduced due to work pressure, etc. A year ago my family doctor referred me to a cardiologist. Again I have done ECG, Complete Blood Count, Blood Biochemistry, Serum Electrolytes, USG of whole abdomen, urine (RE/ME, 24 hrs), etc and they did not show any abnormality. But BP was around 150/110 mmHg. My father is having hypertension as well. The cardiologist prescribed me Nicardia R 10mg twice a day, along with Salt restricted diet. Also he advised me to monitor BP and to repeat the tests every year. I got my ECG done some months back, etc and they did not show any abnormality. But in Blood Lipid Profile - Triglycerides were high i.e. 229.6 mg/dl. Cardiologist monitored BP without stopping tablets; it was around 140/90 mm of Hg and was told that I had essential hypertension (due to family history). Currently I am being prescribed Nicardia R 10 mg twice a day and Olevon at night for 3 months. I measure BP frequently at home using an Digital Blood Pressure Monitor machine and it is consistently around 115/79 mm Hg with pulse rate 75-85. I want to ask the following questions: 1. Am I being over prescribed with these tablets and will they not become a habit during my later years? 2. Do I have only hypertension or some associated side effects as well? If yes, how do I ascertain what is happening inside me? 3. What is the most effective way to come out of this position? 4. Will it be OK for me to marry or will there be any other associated complications? 5. Can anti-hypertensive drugs cause impotence? 6. Do I have go through some more tests to find out the exact reason?

A:There is very little doubt that you are suffering from Essential Hypertension. By its very definition, it means high blood pressure of which there is no apparent cause. No purpose is served by repeated tests such as ECG, Stress ECG etc. Such tests done once every five years would be adequate. You should of course keep a watch over lipids. Hypertension does not produce symptoms in early stages but by the time symptoms appear lot of damage may have been caused on eyes, kidneys, heart etc. Therefore it must be brought down. In your case Nicardia Retard 10 is fine and you should continue with this. It does not cause long term harm. At your age there is hardly any effect either on libido or erectile function. In fact hypertension on its own causes erectile dysfunction (impotence). I fail to see why you are being given Olevon. It has no role in your case except the benefit to the company which sells it. You should continue Yoga if possible. If not, you should at least do brisk walk of 4.5 km in 45 minutes five days a week. This will be helpful in controlling BP and reducing triglycerides. You can take bezafibrate (Bezalip) 200mg three times daily for about four weeks to bring down your TG level. Finally do not stress yourself unnecessarily either over disease or the only drug Nicardia Retard 10mg that is needed by you over long term.